Volumetric Analysis in Autologous Fat Grafting to the Foot.
Adipose Tissue
/ diagnostic imaging
Atrophy
/ complications
Autografts
/ diagnostic imaging
Disability Evaluation
Female
Foot
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Musculoskeletal Pain
/ diagnosis
Pain Measurement
Postoperative Period
Preoperative Period
Prospective Studies
Transplantation, Autologous
/ methods
Treatment Outcome
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
entrez:
29
8
2019
pubmed:
29
8
2019
medline:
18
1
2020
Statut:
ppublish
Résumé
Pedal fat grafting is a safe, minimally invasive approach to treat pedal fat pad atrophy. Prior randomized controlled trials demonstrate that the fat as measured directly under the metatarsal heads disappears between 2 and 6 months after fat grafting, despite patients having relief for 2 years. The authors aim to use magnetic resonance imaging to further assess three-dimensional volume of fat in the foot after autologous fat grafting to help explain the mechanism for improved pain. A prospective study was performed using magnetic resonance imaging before and at 6 months after pedal fat grafting to assess changes in the three-dimensional morphology of the fat. Seventeen patients (six men and 11 women) underwent injections with a mean volume of 5.8 cc per foot. At 6 months, patients demonstrated increased tissue thickness (p = 0.008) and volume (p = 0.04). Improvements were seen in pain (p < 0.05) and activity (p < 0.05). Foot pressures and forces were significantly decreased and positively correlated with increased fat pad volume (p < 0.05). Pedal fat grafting significantly increases metatarsal fat pad volume. The distribution of the fat may contribute to lasting clinical relief in these patients. Therapeutic, IV.
Sections du résumé
BACKGROUND
Pedal fat grafting is a safe, minimally invasive approach to treat pedal fat pad atrophy. Prior randomized controlled trials demonstrate that the fat as measured directly under the metatarsal heads disappears between 2 and 6 months after fat grafting, despite patients having relief for 2 years. The authors aim to use magnetic resonance imaging to further assess three-dimensional volume of fat in the foot after autologous fat grafting to help explain the mechanism for improved pain.
METHODS
A prospective study was performed using magnetic resonance imaging before and at 6 months after pedal fat grafting to assess changes in the three-dimensional morphology of the fat.
RESULTS
Seventeen patients (six men and 11 women) underwent injections with a mean volume of 5.8 cc per foot. At 6 months, patients demonstrated increased tissue thickness (p = 0.008) and volume (p = 0.04). Improvements were seen in pain (p < 0.05) and activity (p < 0.05). Foot pressures and forces were significantly decreased and positively correlated with increased fat pad volume (p < 0.05).
CONCLUSIONS
Pedal fat grafting significantly increases metatarsal fat pad volume. The distribution of the fat may contribute to lasting clinical relief in these patients.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Identifiants
pubmed: 31461044
doi: 10.1097/PRS.0000000000005956
pii: 00006534-201909000-00049
pmc: PMC6716614
mid: NIHMS1527958
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
463e-470eSubventions
Organisme : NCATS NIH HHS
ID : UL1 TR000005
Pays : United States
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